Provider Demographics
NPI:1790428936
Name:COOPER, JOYCE MARIA (RPH)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:MARIA
Last Name:COOPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 WOODBINE ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-2750
Mailing Address - Country:US
Mailing Address - Phone:727-204-6183
Mailing Address - Fax:
Practice Address - Street 1:8830 STATE ROAD 60 W
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:IN
Practice Address - Zip Code:47446-7547
Practice Address - Country:US
Practice Address - Phone:812-849-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS16338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist